- Sedgwick (Atlanta, GA)
- …Adjuster - Southeast Region **PRIMARY PURPOSE** **:** To investigate losses or claims internationally on any size National Account (Maintaining a minimum of five ... be negotiated. + Attends litigation hearings. + Revises case reserves in assigned claims files to cover probably costs. + Prepares loss experience reports to help… more
- Sedgwick (Atlanta, GA)
- …role will be responsible for investigating and adjusting property and casualty claims , both residential and commercial, with little to no supervision. **ESSENTIAL ... Attends litigation hearings. + Revises case reserves in assigned claims files to cover probable costs. + Assists in...other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating… more
- Zurich NA (Atlanta, GA)
- …Diploma or Equivalent and 10 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance Apprentice including an Associate ... and 8 or more years of experience in the Claims or Underwriting Support area AND + Knowledge of...and 14 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance… more
- Molina Healthcare (GA)
- …executive decision-making + Mine and manage information from large data sources. + Analyze claims and other data sources to identify early signs of trends or other ... of provider reimbursement changes + Provide data driven analytics to Finance, Claims , Medical Management, Network, and other departments to enable critical decision… more
- Elevance Health (Atlanta, GA)
- …+ Performs in-depth investigations on identified providers as warranted. + Examines claims for compliance with relevant billing and processing guidelines and to ... prevention and control. + Review and conducts analysis of claims and medical records prior to payment. + Researches...interventions such as recovery of overpayment, pre-payment audit of claims or putting providers on notice. + Assists with… more
- Elevance Health (Atlanta, GA)
- …Specialist III** is responsible for the discovery, validation, recovery, and adjustments of claims overpayments. May do all or some of the following in relation to ... **How you will make an impact:** + Audits paid claims for overpayments using various techniques including systems-based queries,...or equivalent and a minimum of 4 years of claims processing and/or customer service experience; or any combination… more
- CVS Health (Atlanta, GA)
- …bound calls to clients and payers, while working with other teams to resolve claims issues. + Documenting claims details into necessary tools. + Presenting data ... and accurately. **Required Qualifications** + 1+ years of experience working with medical claims with the understanding of how benefit levels are applied. + 1+ years… more
- Sedgwick (Atlanta, GA)
- …or GED required. **Experience** Three (3) years of customer concierge or claims customer service experience or equivalent combination of education and experience ... for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The… more
- Sedgwick (Atlanta, GA)
- …Determines objective, quantifiable, medically supported work restrictions for assigned claims . + Facilitates return-to-work (RTW) efforts through negotiation with ... for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The… more
- Molina Healthcare (GA)
- …for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims ... and provider databases. Synchronizes data among multiple claims systems and application of business rules as they apply to each database. Validate data to be housed on provider databases and ensure adherence to business and system requirements of… more